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Treatment
6.5.3.3. Left Subclavian Artery Management
COR LOE
Recommendations
1 B-NR 1. In patients with descending TAA who undergo TEVAR with
planned left subclavian artery coverage, revascularization of
the left subclavian artery before TEVAR is recommended to
prevent spinal cord injury (SCI) and potentially to reduce
stroke risk and prevent other ischemic complications.
2b C-LD 2. In patients with descending TAA who have undergone
TEVAR with left subclavian coverage and develop SCI
that is unresponsive to an increase in BP or a cerebrospinal
fluid drain, left subclavian artery revascularization may be
considered.
6.5.3.4. Celiac Artery Management
COR LOE
Recommendation
2a B-NR 1. In patients with descending TAA undergoing TEVAR
in whom celiac artery coverage is being considered, it is
reasonable to first confirm adequate collateralization.
6.5.3.5. Ruptured Descending TAA
COR LOE
Recommendations
1 B-NR 1. In patients with ruptured descending TAA who are anatomic
candidates for endovascular repair, TEVAR is recommended
over open repair because of decreased perioperative death and
morbidity.
2b B-NR 2. In patients with ruptured descending TAA undergoing
TEVAR, intentional coverage of the left subclavian artery,
celiac artery, or both may be considered to increase the
landing zone for endovascular repair.
